Class notes for Older Adult Exam 1

Question 1

Is geriatrics or gerontology disease focused?

Answer 1

geriatrics. gerontology is holistic improvement of health

Question 2

life expectancy today in the US

Answer 2

78.5

Question 3

biological maximum length of life that can be achieved under the right circumstances

Answer 3

life span

Question 4

Years of Productive Life

Answer 4

• good outlook on life
• concentration on diet, exercise, decrease in smoking
• advances in technology
• SES
• flu shots, yearly doctor visits, CAM therapies

Question 5

Compression of mortality

Answer 5

We want people to be more or less healthy for a longer period of time

Question 6

Extreme seniors

Answer 6

individuals who continue to be active into their older years e.g. skydiving, motorcycles etc.

Question 7

“spending down”

Answer 7

go through all assets, for an individual needs to keep $1500 everything else needs to be sold and given away until you are considered for medicaid - all of life savings must be spent

Question 8

Communication barriers with the elderly

Answer 8

fear of one’s own aging, fear of showing emotion or being around emotional patients, fear of missing something and needing to write it down, lack of knowledge of patient’s culture, goals, values, unresolved issues (p.51)

Question 9

What factors are considered important to the gerontological nurse?

Answer 9

health mgmt, nutrition, elimination, activity and sleep, cognition and self perception, role, sexuality, values and beliefs, coping and stress (p.52)

Question 10

3 examples of IDL’s

Answer 10

Driving, cooking, writing a check

Question 11

Rolling assessment

Answer 11

Targets at least 1 domain each visit - older adults are usually getting monthly check-ups so a rolling assessment is looking at one screening component each visit is very helpful.

Question 12

Concerns for the elderly

Answer 12

fear of death
institutionalized
loss of independence
not being able to afford to be healthy
pets
being forgotten
embarrassment-a burden
afraid to go to bed bc scared they won’t wake up in morning

Question 13

Tetanus booster (every 10 years) and cholesterol screenings (every 5 years) are considered

Answer 13

primary prevention (p.74)

Question 14

Colonoscopy is recommended every _____ years and is considered secondary prevention

Answer 14

5-7 years

Question 15

OBRA87

Answer 15

requires all states to operate long-term care ombudsmen programs and to notify patients about their rights - residents of homes can make complaints about violation of rights. Aim to limits use of physical and chemical restraints, informed consent/decisional capacity, advanced directives (p.75)

Question 16

Major safety considerations

Answer 16

lighting adequate on stairs?
stair rails?
nonskid surfaces on stairs?
throw rugs?
crowded living room?
tub rails, non slip?
space heaters present?
refrigeration and food ok?
medications properly labeled?
toxic substances away from food?
home adequately ventilated and heated?
safe neighborhood?
fire/police notified of older person in home? (p.409)

Question 17

Conductive hearing loss

Answer 17

sound unable to transmit to inner ear, amplification problems

Question 18

Sensorineural hearing loss

Answer 18

noise-induced hearing loss, harder time with higher pitches

Question 19

Which is a bigger concern? Conductive hearing loss os sensorineural hearing loss?

Answer 19

Sensorineural

Question 20

Bilateral hearing loss may be due to

Answer 20

loud noises affect both sides, lack of cilia, sagging auricle, cerumen harder and drier

Question 21

Weber test

Answer 21

quick screening test for hearing. It can detect unilateral (one-sided) conductive hearing loss (middle ear hearing loss) and unilateral sensorineural hearing loss (inner ear hearing loss).

Question 22

Rinne test

Answer 22

compares air- and bone-conduction hearing. Air-conduction hearing occurs through air near the ear, and bone-conduction hearing occurs through vibrations.

Question 23

When speaking with a hearing impaired individual one should….

Answer 23

eliminate extraneous noise, stand 2-3 feet from patient, have patients attention before speaking, try to LOWER pitch of voice, pause at the end of each sentence, provide assistance with hearing device, make sure the patient can see you, do not cover your mouth or chew gum because some may lip read, speak slowly and clearly, gestures can help, written communication, ask the patient for an oral or written response to see if it was successful

Question 24

What do elderly people want when experiencing hypogeusia (diminished taste)?

Answer 24

sweet and salty foods

Question 25

1 problem for xerostomia (dryness of mouth)?

Answer 25

medications

Question 26

Elderly need approximately this amount of water/day?

Answer 26

1500 ml

Question 27

Reasons for decrease intake of water?

Answer 27

Do not/can not request
Visual impairment
Cannot reach
Predisposition dehydration

Question 28

Sundown Syndrome

Answer 28

agitation as sun goes down, may become violent, family members can help, routine can help, keeping light on in the room can help, helps decrease falls with the light, shadows can get scary sometimes

Question 29

1st sign of infection for elderly?

Answer 29

CONFUSION. 
#1 = UTI
#2 = RESPIRATORY INFECTION

Question 30

Sample pain interview questions (Box 9-3) p. 270

Answer 30

Pain hx, distinguish between acute/chronic pain, location, freq., intensity, alleviating/aggravating factors, associated symptoms, response to current pain meds, meaning of pain

Question 31

If the body doesn’t adjust in 48 hours the sleepiness is not due to the pain med this could mean

Answer 31

end of life issues

Question 32

Start low and

Answer 32

go slow with pain meds - can cause respiratory depression

Question 33

Older adults 65+ should have their vision checked

Answer 33

every 1-2 years

Question 34

Response time for recovering from glare or moving from outdoors to indoors (also known as dark adaptation) is
longer for the older adult. This may be
a key time when the older adult is at a significant risk of

Answer 34

falls

Question 35

50% of adults in the US over 80 have had

Answer 35

cataracts or surgery to remove a cataract

Question 36

Two types of ARMD include

Answer 36

dry and wet. The wet version is more severe and can lead to a quicker progression of visual loss.

Question 37

Suggestions for improving access to healthcare for the elderly

Answer 37

1. improve health insurance coverage
2. outreach services
3. case mgmt care
4. cultural competence and communication
5. improve transportation services